CMS Formulary

Displaying 11651-11660 of 1611142 results.
ID: 11651
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11652
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11653
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861487
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11654
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11655
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 11656
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11657
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 170
Qty Limit Days: 30
ID: 11658
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11659
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11660
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0